A Content analysis of the Fifth Grade Textbooks Based on the Health System Assumptions

xHealth education is an integral part of any education program. Health education curriculums should provide such knowledge, attitudes, and skills that are necessary for improving health. The Comprehensive Health Education Program is designed to promote healthy living and to reduce high-risk health behaviors among all students. News about children and adolescents' health is increasingly occupying the front pages of newspapers and is among the top goals and priorities of the health systems. High-risk preventable health behaviors such as substance use, unhealthy and unprotected sexual behaviors, poor diet, lack of physical activity, non-use of a seat belts, and violence are significantly associated with adolescent morbidity and mortality. Considering the inefficiency of conventional teaching methods and textbooks for promoting student health and with regard to the low level of attention paid to health education, the need for a change in curriculums seems necessary. Furthermore, in order to create change and transformation, and to prevent diseases and increase the efficiency of human resources, as considered in the Fundamental Transformation Document and the Health System Transformation Plan of Iran, it is necessary to pay enough attention to health education of students at a young age. Since school system can have a direct impact on children and adolescents and an indirect impact on adults, it seems that the optimal provision of health education in primary school is one of the most accessible ways of promoting public health. Considering this, the present study was an attempt to examine the components of the health system in the content of the fifth grade textbooks in Iran. A qualitative approach to research and a content analysis method (Shannon's entropy model) were used for conducting this study. More specifically, the present study was done by investigating the participants' viewpoints about the content of the fifth grade textbooks in relation to the 12 major components of physical health, nutritional health, natural environment health, family health, safety incidents, mental health, prevention of high-risk behaviors, control, and prevention of diseases, disability, public health, and school health and also the 58 minor components of health education and promotion. The findings of this study were obtained through a content analysis of all the Iranian fifth grade textbooks and based on the country's health system assumptions. First, the frequency of each of the health components were calculated based on the first step of Shannon entropy model. Then, uncertainty and the coefficient of importance of the obtained data were measured using the second step of Shannon entropy model. As the Findings showed, the highest coefficient of importance was related to the components of nutritional health and the lowest was related to disability. Based on the Findings, the components of health system did not have a normal distribution in the content of Iranian fifth-grade textbooks which had paid very little attention to health education and health promotion of students. Considering this, it should be noted that elementary school textbooks can affect children' attitudes and habits and can play an important role in adult decision-making. Therefore, the elementary school curriculums should be relevant and effective in their design, implementation and evaluation. They should respond to students' emotional and social needs, and satisfy their curiosity, provide them with the necessary knowledge and skills, and increase their hope and boost their inner peace. For this to happen, the following suggestion are offered: paying attention to all components of health education in the content of textbooks; paying attention to the requirements of health education and health promotion; meeting the essential legal, administrative, and financial requirements; providing appropriate facilities and equipment; increasing teachers, principals, parents, employees, and local authorities' awareness of health education and the conditions for health promotion; giving importance to various types of curriculum evaluation both in the curriculum development process and in the implementation process, so that the quality of curriculum products can be controlled and health promotion can be guaranteed; and employing teachers specialized in the field of health education and promotion.